September 2012

Multimodal adaptive rehab improves propulsive impulse in stroke patients

By Jordana Bieze Foster

Gait training on a dual-belt treadmill in an adaptive virtual environment can help improve propulsive impulse in the paretic limbs of individuals with hemiparesis following stroke, according to research from the University of North Carolina at Chapel Hill.

Seven hemiparetic individuals completed 18 training sessions on the university’s Immersive Virtual Environment and Rehabilitation Treadmill. For the three patients with stance time asymmetries, the treadmill was adjusted to encourage quicker steps on the paretic side; for the four patients with step length asymmetries, the treadmill was adjusted for longer steps on that side. The virtual environment gave patients the sense of veering off in one direction with asymmetric gait and maintaining a straight line as gait became more symmetrical.

“It’s harder to tell the patient to ‘push’ to increase propulsion. They end up skating on the treadmill,” said Clinton J. Wutzke, MS, a graduate student in the university’s Human Movement Science program, who presented the findings at the ASB meeting. “It’s easier to tell them to step longer or quicker.”

Propulsive impulse of the paretic limb significantly increased with training. Gait speed also significantly improved.


Wutzke CJ, Lewek MD. Gait training with visual and proprioceptive feedback improves overground propulsive forces in people post-stroke. Presented at the 36th annual meeting of the American Society of Biomechanics; Gainesville, FL; August 2012.

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